Bahr Mahmoud Hussein, Abdelaal Ahmed Mahmoud M Alkhatip Ahmed, Ahmed Ahmed Goda, Elgamel Amira Fouad, Abdelkader Mohamed, Hussein Hazem Abdelwaheb
Department of Anaesthesiology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.
Beni Suef University Hospital, Beni Suef University, Beni Suef, Egypt.
Anesth Pain Med. 2023 Feb 8;13(1):e128782. doi: 10.5812/aapm-128782. eCollection 2023 Feb.
Oxytocin and carbetocin are uterotonic medications that are used to decrease postpartum hemorrhage (PPH). However, there are not enough clinical data about the hemodynamic side effects of carbetocin.
This study aimed to compare carbetocin and oxytocin hemodynamic effects in preeclamptic patients undergoing elective cesarean section under spinal anesthesia.
In this double-blind, randomized controlled trial, intravenous oxytocin or carbetocin was administered to 80 women (40 per group). The hemodynamic effects, such as blood pressure (BP), heart rate (HR), and oxygen (O) saturation, were measured before the operation and after 1, 5, 10, and 15 minutes of the administration of both drugs. Intragroup and intergroup comparisons were conducted during statistical analysis.
Based on the intragroup comparison, there was a significant increase in HR and a reduction in BP from baseline to all intervals after the administration of both interventions. Moreover, based on the intergroup comparison, there was a significantly more increase in HR and a decline in BP and O saturation in the oxytocin group than in the carbetocin group. There were three and seven cases that required another dose of carbetocin and oxytocin, respectively. Moreover, one case developed PPH in the carbetocin group; nevertheless, two cases developed PPH in the oxytocin group.
The minimal effect of carbetocin on patients' hemodynamics suggests extending the use of this drug instead of oxytocin as a uterotonic drug in patients with preeclampsia, hemorrhagic risk factors, and/or hypertension.
缩宫素和卡贝缩宫素是用于减少产后出血（PPH）的宫缩剂。然而，关于卡贝缩宫素血流动力学副作用的临床数据不足。
本研究旨在比较卡贝缩宫素和缩宫素对脊髓麻醉下接受择期剖宫产的子痫前期患者的血流动力学影响。
在这项双盲、随机对照试验中，80名女性（每组40名）接受了静脉注射缩宫素或卡贝缩宫素。在手术前以及两种药物给药后1、5、10和15分钟测量血流动力学效应，如血压（BP）、心率（HR）和氧（O）饱和度。统计分析时进行组内和组间比较。
基于组内比较，两种干预措施给药后，从基线到所有时间段，HR均显著增加，BP均降低。此外，基于组间比较，缩宫素组的HR增加显著更多，BP和O饱和度下降幅度大于卡贝缩宫素组。分别有3例和7例需要额外一剂卡贝缩宫素和缩宫素。此外，卡贝缩宫素组有1例发生PPH；然而，缩宫素组有2例发生PPH。
卡贝缩宫素对患者血流动力学的影响最小，这表明在子痫前期、出血风险因素和/或高血压患者中，可扩大使用该药物替代缩宫素作为宫缩剂。
